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Physiologic Repair of Congenitally Corrected Transposition of the Great Arteries

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Surgery of Conotruncal Anomalies

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Abstract

Surgery for congenitally corrected transposition of the great arteries (ccTGA) has evolved overtime. Anatomical repair of ccTGA is now performed with quite satisfactory outcomes in children. The double switch operation has become the preferred surgical procedure in selected cases. Nevertheless, a number of patients with ccTGA still require physiological repair due to complex cardiac associations or impaired systemic ventricular function. This chapter outlines the mechanisms of right ventricular failure in ccTGA. Several “old techniques of repair” were abandoned. The introduction of PA banding has reduced the occurrence of tricuspid regurgitation and has allowed, in some cases, anatomical repair after proper LV retraining. The indications for TV repair and replacement, the place of the Fontan operation or heart transplantation are discussed. The decision to proceed with physiologic versus anatomic repair and the timing of operation is individualized.

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Author information

Authors and Affiliations

  1. Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN, USA

    Sameh M. Said MD

  2. Department of Cardiovascular Surgery, Mayo Clinic, 200 First Street, SW, Rochester, MN, 55905, USA

    Joseph A. Dearani MD

Authors
  1. Sameh M. Said MD
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  2. Joseph A. Dearani MD
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Correspondence to Joseph A. Dearani MD .

Editor information

Editors and Affiliations

  1. Royal Brompton Hospital, London, United Kingdom

    Francois Lacour-Gayet

  2. C.S. Mott Children’s Hospital, University of Michigan, Ann Arbor, Michigan, USA

    Edward L. Bove

  3. German Pediatric Heart Center, Asklepios Klinik Sankt Augustin Gmb, Sankt Augustin, Germany

    Viktor Hraška

  4. University of Pittsburgh Medical School, Pittsburgh, Pennsylvania, USA

    Victor O. Morell

  5. Department of Cardiothoracic Surgery, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA

    Thomas L. Spray

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© 2016 Springer International Publishing Switzerland

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Said, S.M., Dearani, J.A. (2016). Physiologic Repair of Congenitally Corrected Transposition of the Great Arteries. In: Lacour-Gayet, F., Bove, E., Hraška, V., Morell, V., Spray, T. (eds) Surgery of Conotruncal Anomalies. Springer, Cham. https://doi.org/10.1007/978-3-319-23057-3_29

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  • DOI: https://doi.org/10.1007/978-3-319-23057-3_29

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-23056-6

  • Online ISBN: 978-3-319-23057-3

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